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Contact Information

MARIE B BLACKER, PMHNP-C
1125 W CENTER ST
OREM, UT84057-5207
 Phone: 801-903-5903
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatric/Mental Health

363LP0808X 50 Nurse Practitioner
 

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for MARIE B BLACKER · (Female)

NPI Number 1326521543
Status Active
Credentials PMHNP-C
Entity Individual
Enumeration date 09/13/2018
Last updated 03/13/2026 - About 3 months ago
Sole proprietor 1 No
Identifiers
  • SC License # 28201
  • UT License # 267381-4405
  • UT Medicaid 1477985513
Hospital affiliation(s)
  • UTAH VALLEY REGIONAL MEDICAL CENTER - (Acute Care)
    1034 NORTH 500 WEST
    PROVO, UT 84604
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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